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Legislation Overview

Given the continued fiscal challenges posed by administering health care programs, policy makers and regulators should continue to focus on fostering innovative methods of health care delivery that offer safe, high-quality care so progressive changes in the nation’s health care system can be implemented.

Support should be reserved for those policies that foster competition and promote the utilization of sites of service providing more affordable care, while always maintaining high quality and stringent safety standards. In light of the many benefits ASCs have brought to the nation’s health care system, policymakers should develop and implement payment and coverage policies that increase access to, and utilization of, ASCs.

The ASC Quality & Access Act of 2015 would move the ASC reimbursement update from the Consumer Price Index for All Urban Consumers (CPI-U) to the hospital market basket update, which better measures the cost of practicing medicine;

This legislation would also require CMS to post similar quality metrics of ASCs and HODPs online in a “side-by-side comparison.” The publicly available data would include quality measures and copay amounts for both sites of service in the same geographic area;

Under current law, Medicare waives coinsurance and deductibles for colonoscopies. When a polyp is discovered and removed, the procedure is reclassiﬁed as therapeutic for Medicare billing purposes and patients are required to pay the coinsurance. The Removing Barriers to Colorectal Screening Act of 2015 would eliminate unexpected costs for Medicare beneﬁciaries when a polyp is discovered and removed, ensuring that unexpected copays do not deter a patient from having the screening performed.

By eliminating ﬁnancial barriers, this legislation would attain higher screening rates and reduce the incidence of colorectal cancer.